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Responsibilities:
- Manage pre-service authorization denials and coordinate appeals, reconsiderations, peer-to-peer reviews, and payer exception requests.
- Interpret payer policies and coverage requirements to guide complex cases and resolution pathways.
- Collaborate with providers, payers, and internal teams to obtain supporting documentation and resolve barriers.
Qualifications:
- 3–5 years of experience in prior authorization, denial management, or appeals required.
- Strong knowledge of commercial and government payer requirements including Medicare and Medicaid.
- Excellent analytical, communication, and organizational skills with EMR proficiency.
About IVX Health:
- National provider of infusion and injection therapy for chronic conditions.
- Culture built on collaboration, innovation, and purpose with values like Be Kind and Never Settle.
- Commitment to professional development and meaningful work.
IVX Health
IVX Health is a national provider of infusion and injection therapy for patients managing complex chronic conditions. They are a growing healthcare organization with a culture built on collaboration, innovation, and purpose, offering professional development and meaningful work.